Unplanned admission after gastrectomy as a consequence of fast-track surgery

a comparative risk analysis

Michitaka Honda, Naoki Hiki, Souya Nunobe, Manabu Ohashi, Shinji Mine, Masayuki Watanabe, Satoshi Kamiya, Tomoyuki Irino, Takeshi Sano, Toshiharu Yamaguchi

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: The objectives of this study were to evaluate the incidence of and the risk factors for readmission after gastrectomy. Our hypothesis was that early discharge may be related to an increase in the incidence of readmission. Methods: This was a retrospective, single-center, observational study of 1442 patients who underwent gastrectomy for stage I gastric cancer. The main outcome was the incidence of early readmission after gastrectomy, which was defined as an admission within 6 months after the first discharge day. A stepwise logistic regression analysis was conducted to identify the risk factors for readmission after gastrectomy. Results: The surgical procedures performed were total gastrectomy in 217 patients (15.0 %), distal gastrectomy in 845 patients (58.6 %), pylorus-preserving gastrectomy in 342 patients (23.7 %), and proximal gastrectomy in 37 patients (2.6 %). The median hospital stay was 11 days, and there were 63 readmissions for a total of 56 patients (3.8 %). The main reasons for readmission were poor food intake in 14 patients (22.2 %), anastomotic stricture in nine patients (14.3 %), small bowel obstruction in eight patients (12.7 %), and an abdominal distension in seven patients (11.1 %). Endoscopic balloon dilation was performed for the nine patients with anastomotic stricture, drainage was needed for the four patients with an intra-abdominal abscess, and laparotomy was performed for one patient with adhesion-associated bowel obstruction. The long hospitalization during the primary admission and patients who underwent total gastrectomy were risk factors for readmission. Conclusions: Patients with a long hospital stay after gastrectomy are at an increased risk of early readmission, which was likely related to the incidence of severe sequelae specific to gastrectomy.

Original languageEnglish
Pages (from-to)1002-1007
Number of pages6
JournalGastric Cancer
Volume19
Issue number3
DOIs
Publication statusPublished - 2016 Jul 1
Externally publishedYes

Fingerprint

Gastrectomy
Incidence
Length of Stay
Pathologic Constriction
Abdominal Abscess
Patient Admission
Pylorus
Laparotomy
Stomach Neoplasms
Observational Studies
Dilatation
Drainage
Hospitalization
Eating
Logistic Models
Regression Analysis

Keywords

  • Gastric cancer
  • Readmission
  • Risk factor
  • Surgery

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology
  • Cancer Research

Cite this

Honda, M., Hiki, N., Nunobe, S., Ohashi, M., Mine, S., Watanabe, M., ... Yamaguchi, T. (2016). Unplanned admission after gastrectomy as a consequence of fast-track surgery: a comparative risk analysis. Gastric Cancer, 19(3), 1002-1007. https://doi.org/10.1007/s10120-015-0553-5

Unplanned admission after gastrectomy as a consequence of fast-track surgery : a comparative risk analysis. / Honda, Michitaka; Hiki, Naoki; Nunobe, Souya; Ohashi, Manabu; Mine, Shinji; Watanabe, Masayuki; Kamiya, Satoshi; Irino, Tomoyuki; Sano, Takeshi; Yamaguchi, Toshiharu.

In: Gastric Cancer, Vol. 19, No. 3, 01.07.2016, p. 1002-1007.

Research output: Contribution to journalArticle

Honda, M, Hiki, N, Nunobe, S, Ohashi, M, Mine, S, Watanabe, M, Kamiya, S, Irino, T, Sano, T & Yamaguchi, T 2016, 'Unplanned admission after gastrectomy as a consequence of fast-track surgery: a comparative risk analysis', Gastric Cancer, vol. 19, no. 3, pp. 1002-1007. https://doi.org/10.1007/s10120-015-0553-5
Honda, Michitaka ; Hiki, Naoki ; Nunobe, Souya ; Ohashi, Manabu ; Mine, Shinji ; Watanabe, Masayuki ; Kamiya, Satoshi ; Irino, Tomoyuki ; Sano, Takeshi ; Yamaguchi, Toshiharu. / Unplanned admission after gastrectomy as a consequence of fast-track surgery : a comparative risk analysis. In: Gastric Cancer. 2016 ; Vol. 19, No. 3. pp. 1002-1007.
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AU - Honda, Michitaka

AU - Hiki, Naoki

AU - Nunobe, Souya

AU - Ohashi, Manabu

AU - Mine, Shinji

AU - Watanabe, Masayuki

AU - Kamiya, Satoshi

AU - Irino, Tomoyuki

AU - Sano, Takeshi

AU - Yamaguchi, Toshiharu

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N2 - Background: The objectives of this study were to evaluate the incidence of and the risk factors for readmission after gastrectomy. Our hypothesis was that early discharge may be related to an increase in the incidence of readmission. Methods: This was a retrospective, single-center, observational study of 1442 patients who underwent gastrectomy for stage I gastric cancer. The main outcome was the incidence of early readmission after gastrectomy, which was defined as an admission within 6 months after the first discharge day. A stepwise logistic regression analysis was conducted to identify the risk factors for readmission after gastrectomy. Results: The surgical procedures performed were total gastrectomy in 217 patients (15.0 %), distal gastrectomy in 845 patients (58.6 %), pylorus-preserving gastrectomy in 342 patients (23.7 %), and proximal gastrectomy in 37 patients (2.6 %). The median hospital stay was 11 days, and there were 63 readmissions for a total of 56 patients (3.8 %). The main reasons for readmission were poor food intake in 14 patients (22.2 %), anastomotic stricture in nine patients (14.3 %), small bowel obstruction in eight patients (12.7 %), and an abdominal distension in seven patients (11.1 %). Endoscopic balloon dilation was performed for the nine patients with anastomotic stricture, drainage was needed for the four patients with an intra-abdominal abscess, and laparotomy was performed for one patient with adhesion-associated bowel obstruction. The long hospitalization during the primary admission and patients who underwent total gastrectomy were risk factors for readmission. Conclusions: Patients with a long hospital stay after gastrectomy are at an increased risk of early readmission, which was likely related to the incidence of severe sequelae specific to gastrectomy.

AB - Background: The objectives of this study were to evaluate the incidence of and the risk factors for readmission after gastrectomy. Our hypothesis was that early discharge may be related to an increase in the incidence of readmission. Methods: This was a retrospective, single-center, observational study of 1442 patients who underwent gastrectomy for stage I gastric cancer. The main outcome was the incidence of early readmission after gastrectomy, which was defined as an admission within 6 months after the first discharge day. A stepwise logistic regression analysis was conducted to identify the risk factors for readmission after gastrectomy. Results: The surgical procedures performed were total gastrectomy in 217 patients (15.0 %), distal gastrectomy in 845 patients (58.6 %), pylorus-preserving gastrectomy in 342 patients (23.7 %), and proximal gastrectomy in 37 patients (2.6 %). The median hospital stay was 11 days, and there were 63 readmissions for a total of 56 patients (3.8 %). The main reasons for readmission were poor food intake in 14 patients (22.2 %), anastomotic stricture in nine patients (14.3 %), small bowel obstruction in eight patients (12.7 %), and an abdominal distension in seven patients (11.1 %). Endoscopic balloon dilation was performed for the nine patients with anastomotic stricture, drainage was needed for the four patients with an intra-abdominal abscess, and laparotomy was performed for one patient with adhesion-associated bowel obstruction. The long hospitalization during the primary admission and patients who underwent total gastrectomy were risk factors for readmission. Conclusions: Patients with a long hospital stay after gastrectomy are at an increased risk of early readmission, which was likely related to the incidence of severe sequelae specific to gastrectomy.

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